Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Danielle Gunter


Background. Missed follow-up appointments constitute significant problems clinics and health centers face nationwide. A significant portion of primary care providers’ patients will require follow-up appointments to manage their chronic illnesses. About 20 to 40% of patients seen at this clinic have a history of hypertension. Uncontrolled hypertension has been shown to increase the risk of certain cardiovascular disease events and mortality. Follow-up appointments are crucial for patients with hypertension to monitor for more life-threatening signs and manage their overall care. Purpose. The purpose of this project is to improve the timely management of care for patients with hypertension through the implementation of a new appointment reminder process and policy addressing missed appointments in a primary care clinic. Methodology/Results. Data through the EHR was obtained on 90 patients. Among these patients, 55% had hypertension as their primary diagnosis. After 19 weeks of implementation, the rate of missed appointments decreased by 4%, and for patients with hypertension, there was a reduction in blood pressure by 9/4mmHg. Implications for practice. This project’s findings may help create a culture of continuous improvement by raising knowledge of evidence-based strategies that work in primary care practices to reduce missed appointments. Results may also lead to better management of disease processes, improved patient health outcomes, and increased clinic revenue.